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This study is a multicenter, prospective, randomized, open-label clinical study to assess the efficacy and safety of endocrine combined with different doses and treatment duration of darisenatide adjuvant therapy in HR +/HER2- early breast cancer. The study planned to include 2000 HR +/HER2- early breast cancer patients who met the study criteria and were randomized in a 1:1 ratio to Column 1 and Column 2 stratified by nodal status (positive/negative), prior (neo) adjuvant chemotherapy (yes/no), and clinical/pathological stage (Stage II/III).
Cohort 1 received dalcili 125 mg in combination with endocrine therapy for 2 years with dalcili; Cohort 2 received dalcili 100 mg in combination with endocrine therapy for 3 years with dalcili; treatment had to be discontinued until disease progression, intolerable adverse events, withdrawal of consent, or investigator judgment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Column 1 | Experimental | Dalpiciclib: 125 mg, once daily, taken at approximately the same time every day, fasting 1 hour before and after taking the drug, for 21 consecutive days, followed by 7 days off, 28 days as a treatment cycle.It was administered for 2 years. Endocrine therapy: endocrine therapy drugs selected by the investigator, including aromatase inhibitors (AI), fulvestrant, tamoxifen, toremifene, etc. |
|
| Column 2 | Experimental | Dalpiciclib: 100 mg, once daily, taken at approximately the same time every day, fasting 1 hour before and after taking the drug, for 21 consecutive days, followed by 7 days off, 28 days as a treatment cycle. It was administered for 3 years. Endocrine therapy: endocrine therapy drugs selected by the investigator, including aromatase inhibitors (AIs), fulvestrant, tamoxifen, toremifene, etc. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dalpiciclib 125mg | Drug | Dalpiciclib: 125 mg, once daily, taken at approximately the same time every day, fasting 1 hour before and after taking the drug, for 21 consecutive days, followed by 7 days off, 28 days as a treatment cycle. It was administered for 2 years. |
| Measure | Description | Time Frame |
|---|---|---|
| 3-year invasive disease-free survival | Defined as the time from the date of enrollment until the first occurrence of one of the following iDFS events: invasive ipsilateral or contralateral recurrent breast cancer, local or regional recurrence, distant metastasis, and death from any cause. | Observed from enrollment through 3 years. |
| Measure | Description | Time Frame |
|---|---|---|
| Distant Disease- Free Survival | From the date of enrollment until the first distant relapse or death from any cause. | Observed from enrollment through 3 years. |
| overall survival | Time from enrollment to death from any cause. |
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Inclusion Criteria:
Female aged 18 years or older with breast cancer who are postmenopausal or premenopausal/perimenopausal.
Patients with early-stage breast cancer whose HR status is positive and HER2 status is negative, as confirmed by histology (immunohistochemistry showing ER ≥10% and/or PR ≥10%, HER2 0-1+ or HER2 ++ but negative by FISH or CISH testing, with no amplification).
Patients with histologically confirmed invasive breast cancer at clinical/pathological stages II-III.
Note: For stage IIA, N1 is required, or N0 with Grade 3 or Grade 2 tumors combined with high-risk factors such as Ki-67 ≥20% or positive genetic testing (including but not limited to high-risk results in the 21-gene test). If the patient has previously received neoadjuvant therapy, the clinical stage at the time before neoadjuvant therapy must meet the above criteria.
Patients who have previously received or not received neoadjuvant chemotherapy or adjuvant chemotherapy are eligible to enroll.
The time interval from surgery to enrollment must not exceed 12 months.
Patients who have received radiotherapy must have recovered from the acute effects of radiotherapy, and there must be at least 14 days of washout period from the end of radiotherapy to enrollment.
Patients who have previously received chemotherapy must have recovered from the acute adverse effects of chemotherapy before enrollment ([CTCAE] grade ≤1), except for hair loss or grade 2 peripheral neuropathy.There must be a washout period of at least 21 days between the last administration of chemotherapy and enrollment in the study. 8. The Eastern Cooperative Oncology Group performance status score must be 0-1. 9. The functions of major organs must meet the following requirements: a) Blood tests: neutrophils (ANC) ≥1.5×10^9/L; platelet count (PLT) ≥90×10^9/L; hemoglobin (Hb) ≥90 g/L. b) Blood biochemistry tests: total bilirubin (TBIL) ≤2.5×ULN; alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤1.5×ULN; alkaline phosphatase ≤2.5×ULN; blood urea nitrogen (BUN) and creatinine (Cr) ≤1.5×ULN. c) 12-lead electrocardiogram: QT interval corrected using the Fridericia method (QTcF) < 470 ms in females (QTcF calculation formula: QTcF = QT/(RR^1/3)). Participants must voluntarily agree to participate in the study, sign the informed consent form, demonstrate good compliance, and be willing to cooperate with follow-up assessments.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Chuangui Song, doctor | Contact | 13960709993 | songcg1971@outlook.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fujian Cancer Hosptial | Recruiting | Fuzhou | Fujian | 350001 | China |
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| Dalpiciclib 100mg | Drug | Dalpiciclib: 100 mg, once daily, taken at approximately the same time every day, fasting 1 hour before and after taking the drug, for 21 consecutive days, followed by 7 days off, 28 days as a treatment cycle. It was administered for 3 years. |
|
| Endocrine Therapy (ET): letrozole, anastrozole, exemestane, tamoxifen | Drug | Endocrine therapy: endocrine therapy drugs selected by the investigator, including aromatase inhibitors (AIs), fulvestrant, tamoxifen, toremifene, etc. |
|
| Observed from enrollment through 3 years. |
| Patient Reported Outcomes | Collected by EORCT QLQ-C30 Quality of Life Scale | Evaluations are conducted every 3 months in the first year, and every half month in the second and third years. |
| Safety Results | Record adverse events (AEs) and serious adverse events (SAEs) separately in accordance with the NCI CTC AEv5.0 criteria. | From the time of enrollment until 30 days after the completion of the medication regimen |
| West China Hospital of Sichuan University | Not yet recruiting | Chengdu | Sichuan | 618099 | China |
|
| ID | Term |
|---|---|
| D001941 | Breast Diseases |
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| C000720752 | dalpiciclib |
| D000077384 | Anastrozole |
| C056516 | exemestane |
| D013629 | Tamoxifen |
| ID | Term |
|---|---|
| D009570 | Nitriles |
| D009930 | Organic Chemicals |
| D014230 | Triazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D013267 | Stilbenes |
| D001597 | Benzylidene Compounds |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
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